Marlfield Care Home With Nursing

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care plans reflected their physical, mental, emotional and social needs, including those related to their protected characteristics under the Equality Act 2010. They were person centred and reflected people’s needs and preferences as individuals.

People’s care plans were reviewed through the provider's monthly, “Resident of the Day” process which enabled the person to engage with staff from all departments. To enjoy a meal of their choosing and to discuss with staff their ongoing needs and any changes. A relative said of the process, “They [staff] go through her care plan, discuss things and check on everything. The person has a shower or bath that day, their favourite meal and are spoilt”. They continued “At the end of the day, they contact the relative and update them and ask if they have any questions or concerns.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People's care plans reflected any support in place for them from other services. Partners told us staff managed people's behaviour's well particularly when they were complex, which provided them with continuity of care, as they could continue to be supported within the service. Staff ensured if people required extra support for example, for one to one care, this was identified and requested.

Agency staff were provided by 1 of 2 agencies, 1 which supplied nursing staff and the other care staff, which enabled continuity for people.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff assessed people's communication needs as part of their initial assessment and documented how these were to be met. People could be provided with information in various formats which suited their needs, including audio, braille, or large print. Staff could also access interpreter services for people if required.

People's permission to share information about them for example, via GP Connect and telemedicine was sought. People’s wishes regarding whom information could be shared with were clearly recorded.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a complaints process. People and relatives told us they could raise any concerns and said if issues were raised then they were promptly addressed. A relative said, “There have been some teething problems but it’s all sorted quickly.” Processes were in place to have monthly oversight of any complaints or compliments.

The provider also sought feedback via both residents and relatives’ meetings. They were developing standardised surveys, to replace existing surveys; for use across all their locations. To enable greater analysis and insight of both individual services and across locations.

People who were unable to represent their views or who lacked someone to do this for them were supported by staff to access advocacy services.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service was purpose built and had wide corridors, a lift, ensuite rooms and large bath/shower rooms. The home is accessible for people who use wheelchairs or mobility equipment.

The home is surrounded by a large, sloped garden. Although there is a path, parts of the garden remain inaccessible if people have impaired mobility. However, the provider has improved the home’s central courtyard which everyone can access, through the provision of a fountain and sensory planting.

Whilst staff and leaders listened to information about people who are most likely to experience inequality in experience or outcomes. Aspects of people’s care and the environment were not always tailored in response.

Staff completed training on both inclusion and diversity and living with dementia. Staff could also access professional guidance and support for advice about dementia care as required.

However, whilst improvements had been made, some aspects of both the environment and processes were not fully inclusive. The environment had some dementia friendly features such as signage and coloured bathroom doors and toilet seats to aid people’s recognition, but there was a lack of personalised cues to support people to orientate themselves. Through the use of memory boxes or visual information to enable people to differentiate the corridors.

People living with dementia benefit from making their choices at the time they need to be made. We saw whilst people were shown the choice of drinks at lunchtime which helped them to choose, they were not also provided with ‘show plates’ or other alternatives to help them choose their meal. People chose their meals the day before, although they could then change their mind when the meal was served. The provider has told us they will review their process.

We also saw menus were not available in a pictorial format if required. The provider has since told us they are now working with both kitchen staff and the wellbeing lead for the service to develop picture menus.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s preferences about their future care were sought and recorded where they had expressed their wishes. People had Recommended Summary Plan for Emergency Care and Treatment (ReSPECT forms) in place. These document personalised recommendations for emergency medical care in situations where the person might not be unable to make or communicate decisions about their care.

Staff had completed end of life care training and told us they felt supported both internally and by relevant professionals to provide people with good end of life care. The registered manager told us the staff team prided themselves on ensuring people’s comfort at the end of their lives. Staff confirmed, how they ensured people were cared for and kept comfortable.